Remote Complex Claims & Coverage Director

Mercor; San Francisco (CA); Hybrid; GBP 729,000 - 938,000; Part time

Job summary

Mercor is seeking a Complex Claims & Coverage Director for a remote, contract role offering 20–40 hours per week. The start is immediate, with an AI interview-based application process.

You will design strategies for disputed coverage and provide senior-level analyses and escalation guidance. Responsibilities include creating claim strategies, performing coverage analyses, and drafting high-quality responses.

Qualifications

• 2+ years of professional experience handling complex, litigated, high-severity, or coverage-sensitive insurance claims.
• Experience evaluating coverage issues and developing claim strategies involving multiple parties, layers, policies, or jurisdictions.
• Understanding of insurer duties, reservation-of-rights practices, litigation management, settlement authority, and escalation to internal or external counsel.
• Ability to distinguish an operational coverage position from formal legal advice and recognize when specialized legal review is required.
• Exceptional written reasoning, defensible judgment, and high attention to detail.
• Comfort with reviewing incomplete records and clearly separating facts, assumptions, open issues, and recommended next steps.

Responsibilities

• Design realistic scenarios involving disputed coverage, reservations of rights, excess exposure, multiple insureds, multiple carriers, allocation, litigation, mediation, bad‑faith risk, and high‑severity settlement strategy.
• Create work products such as complex claim strategies, coverage-position analyses, authority requests, litigation-management plans, reserve rationales, and escalation recommendations.
• Write "golden" reference responses at senior technical claims quality.
• Grade AI-generated responses against structured rubrics for policy analysis, strategic judgment, factual support, stakeholder awareness, and escalation discipline.
• Identify claim-handling positions that are internally inconsistent, unsupported by the record, operationally unrealistic, or outside the authority of a non-lawyer claims professional.
• Provide written feedback the research team uses to improve model behavior.

Skills

Complex claims handling

Litigation coordination

Policy analysis

Written communication

Attention to detail

Education

CPCU / AIC / SCLA / ARM or comparable designation

Job description

Mercor is seeking a Complex Claims & Coverage Director for a remote, contract role offering 20–40 hours per week. The start is immediate, with an AI interview-based application process.

You will design strategies for disputed coverage and provide senior-level analyses and escalation guidance. Responsibilities include creating claim strategies, performing coverage analyses, and drafting high-quality responses.